At Our Medical Practice, It’s Relationships over Bigger Raises

We don’t often give raises. Believe it or not, our employees actually prefer this.

Instead we give an annual performance review “bonus” which is tied directly to our employees’ performance. Most employees, most years, are within the 90th percentile of their possible performance, and we award, for example 95 percent of their target bonus if they score a 95 percent. I keep the review spreadsheet form simple, just enough information to make sure we are on the same page and can discuss it if we are not. This simplicity was important for me; I’ve done performance reviews and appraisals at other companies and they can be very complicated and confusing. My feeling is that it’s not always beneficial for the employee to have an overly-detailed, convoluted review. Our process provides a chance for feedback for the employees and gives us a chance to discuss anything that comes up in the review process.

When we do the annual review, the physician has to sign off on it before I review with the employee. At a little more than two weeks pay, the money is about the same, but they get a lump sum and at that pay range, they appreciate it more. If we gave raises, we’d be tied to that pay for rest of their employment, and it also doesn’t make sense to give COLA raises. All our employees understand that physicians don’t receive COLA raises, so they can’t be passed on.

Holiday bonuses are given between Thanksgiving and Christmas. The amount employees get depends on how long they have been at our practice. Even if you’ve only been on the team for a month, you get something. We split this bonus up over two paychecks to minimize the impact on our cash flow. In this way, we can give the bonuses before Christmas.

Regarding a holiday party, we live in a small town about an hour south of Houston. Basically this means no upscale restaurants in our area. Chili’s is it, and because we go there every week we decided to do something else instead.

We rent a “bus” and take everyone and their spouses to dinner in Houston. We have a great time and everyone seems to really enjoy it. We get to meet each other’s spouses and get to know each other outside of work.

It might sound cliché but it’s a great bonding experience for us. We all have spouses, kids, etc., so our lives outside are typically too busy to socialize outside of work. We all work hard during the year and this is a great reward.

Each year I ask if they would like to opt out of the dinner and just get a larger bonus. The answer is a resounding “No!” They all want dinner.

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